scholarly journals Third Molar: Optional Tooth

2020 ◽  
Vol 5 (8) ◽  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Specific Situation ◽  
Third Molars ◽  
Poor Oral Hygiene ◽  
Second Molar ◽  
The Third ◽  
Clinical Procedures ◽  
Recommended Treatment ◽  
Close Proximity

There is always a nagging question, which heightens my curiosity on the appropriate removal of an impacted third molar in this specific situation: What if you have a carious or beyond-repair second molar or second bicuspid? Will you try to heroically upright the mesially and horizontally impacted third molars? How about resorbed second molar or a third molar in close proximity of mandibular inferior alveolar nerve. Uprighting of mesially impacted tilted molars is the recommended treatment and should be done as soon as possible. If not properly corrected, mesially impacted molars may lead to complications such as elongation of opposing teeth, periodontal problems on the mesial side of the affected teeth, caries in the unerupted molars, temporomandibular disorders and poor oral hygiene. Some clinical procedures have been used to upright the third molar. Is it really worth working to leave the third molar be uprighted or have it surgically removed? As most maxillofacial oral surgeons, prefer

scholarly journals Evaluation of Panoramic Radiographs in Relation to the Mandibular Third Molar and to Incidental Findings in an Adult Population

2020 ◽  
Author(s):  
Josefine Cederhag ◽  
Nina Lundegren ◽  
Per Alstergren ◽  
Xie-Qi Shi ◽  
Kristina Hellén-Halme
Keyword(s):  
Incidental Findings ◽  
Adult Population ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Patient Positioning ◽  
Vertical Position ◽  
Surgical Removal ◽  
Third Molars ◽  
Panoramic Radiographs ◽  
The Third

Abstract Objectives The aim was to evaluate the characteristics of the mandibular third molars, especially in relation to the inferior alveolar nerve. Further aims were to investigate incidental findings in panoramic radiographs in an adult population, and to investigate image quality related to patient positioning. Materials and Methods From a previous study with 451 randomly selected adult participants who lived in Sweden, 442 panoramic radiographs from four dental public health clinics were used. The third molars’ characteristics and relation to inferior alveolar nerve were evaluated. Incidental findings and patient positioning were recorded. Statistical Analysis Frequency analysis was used to investigate the occurrence of all findings and their possible interconnections. Whether the patients’ age or gender had an impact or not was also analyzed. Results The third molars were erupted in vertical position among 73% regardless of age. When retained or semi-retained, they were most commonly in mesioangular positions. The inferior alveolar nerve was located inferior to the roots in 52%, whereas an overlapped position was most common if the third molar was retained (90%), semi-retained (83%) or the age was less than 30 years (66%). Common incidental findings were apical radiolucencies, idiopathic osteosclerosis, and tooth fragments. Suboptimal patient positioning was found in one-third of the radiographs. Conclusions Panoramic radiography is a useful method to evaluate third molar prior to surgical removal and may be the only image required. Most incidental findings on panoramic radiographs does not seem to require any further odontological management.

scholarly journals Accuracy of cone-beam computed tomography in defining spatial relationships between third molar roots and inferior alveolar nerve

2016 ◽  
Vol 10 (04) ◽  
pp. 454-458 ◽  
Author(s):  
Roberto Pippi ◽  
Marcello Santoro ◽  
Ferdinando D'Ambrosio
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Morphology ◽  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Root Surface ◽  
Cone Beam ◽  
Spatial Relationships ◽  
Third Molars ◽  
The Third

ABSTRACT Objective: Cone-beam computed tomography (CBCT) has been proposed in surgical planning of lower third molar extraction. The aim of the present study was to assess the reliability of CBCT in defining third molar root morphology and its spatial relationships with the inferior alveolar nerve (IAN). Materials and Methods: Intraoperative and radiographic variables of 74 lower third molars were retrospectively analyzed. Intraoperative variables included IAN exposure, number of roots, root morphology of extracted third molars, and presence/absence of IAN impression on the root surface. Radiographic variables included presence/absence of the cortex separating IAN from the third molar roots on CBCT examination, number of roots and root morphology on both orthopantomography (OPG) and CBCT. The statistical association between variables was evaluated using the Fisher's exact test. Results: In all cases of intraoperative IAN exposure, the cortex appeared discontinuous on CBCT images. All cases, in which the cortical bone was continuous on CBCT images, showed no association with nerve exposure. In all cases in which nerve impression was identified on the root surface, the IAN cortex showed interruptions on CBCT images. No nerve impression was identified in any of the cases, in which the cortex appeared continuous on CBCT images. CBCT also highlighted accessory roots and apical anomalies/curvatures, not visible on the OPG. Conclusions: CBCT seems to provide reliable and accurate information about the third molar root morphology and its relationship with the IAN.

scholarly journals Factors associated with spontaneous mesialization of impacted mandibular third molars after second molar protraction

2019 ◽  
Vol 90 (2) ◽  
pp. 181-186
Author(s):  
Un-Bong Baik ◽  
Jin Hye Kang ◽  
Ui-Lyong Lee ◽  
Nikhilesh R Vaid ◽  
Yoon-Ji Kim ◽  
...  
Keyword(s):  
Third Molar ◽  
Regression Analyses ◽  
Third Molars ◽  
Second Molar ◽  
Factors Associated ◽  
The Third ◽  
Mandibular Second Molar ◽  
Impacted Mandibular Third Molars ◽  
Mandibular Third Molars ◽  
Mandibular First Molar

ABSTRACT Objectives: To investigate factors associated with spontaneous mesialization of impacted third molars after second molar protraction to close the space caused by a missing mandibular first molar (L-6) or retained deciduous mandibular second molars with a missing succedaneous premolar (L-E). Materials and Methods: Panoramic radiographs of patients treated with mandibular second molar protraction to close the space due to missing L-6 or L-E (14 males, 36 females, mean age = 18.6 ± 4.4 years) were analyzed before treatment (T1) and after second molar protraction (T2). Factors associated with the amount of third molar mesialization were investigated using regression analyses. Results: Mandibular second molars were protracted by 5.1 ± 2.1 mm and 5.8 ± 2.7 mm, measured at the crown and root furcation, respectively. After second molar protraction, third molars showed spontaneous mesialization by 4.3 ± 1.6 mm and 3.8 ± 2.6 mm, measured at the crown and root furcation, respectively. Nolla's stage of the third molar at T1 (B = 0.20, P = .026) and second molar protraction time (B = 0.04, P = .042) were significantly associated with the amount of third molar mesialization. Conclusions: Greater third molar mesialization was observed when Nolla's stage of the third molar was higher before treatment and when the second molar protraction time was longer.

Evaluation of Mandibular Third Molar Region in a Turkish Population Using Cone-Beam Computed Tomography

2020 ◽  
Vol 16 (9) ◽  
pp. 1105-1110
Author(s):  
Büyük Kaan Orhan ◽  
Dilek Yılmaz ◽  
Mehmet Ozgur Ozemre ◽  
Kıvanç Kamburoğlu ◽  
Orhan Gulen ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Third Molar ◽  
Mandibular Canal ◽  
Third Molars ◽  
Second Molar ◽  
The Third ◽  
Impacted Mandibular Third Molar ◽  
Mandibular Third Molar ◽  
The Relationship ◽  
Molar Region

Objectives: To evaluate impacted mandibular third molar tooth region and obtain linear measurements using CBCT images and to assess the relationship between the impacted third molar and the mandibular canal. Methods: CBCT scans of 351 patients (208 females, 143 males) were assessed. Age, gender, and impaction site were recorded for each patient. The relationship of third molars with the vertical axis of second molars, 2nd molar resorption and the relationship between third molar apices and the mandibular canal were assessed. In addition, the distance between ramus and second molar, mesiodistal width of the third molar, the angle between third molar and second molar, and width of the third molar capsule were measured. Binary Logistic Regression, Chi-Square Test, and General Linear Model were used for statistical analysis. Results: The highest percentage of impaction was found for mesioangular followed by transversal and vertical. The transversal impacted third molars revealed a significant association with adjacent second molar root resorption (p<0.001). There was a statistical significance between the second molar resorption and distance between ramus and second molar (p<0.001). The mesioangular impacted third molars revealed significant relation with the mandibular canal (p<0.05). The most frequent variation found was the dental canal followed by the retromolar canal. In general, higher measurement values were obtained for men when compared to women (p<0.05). Conclusion: CBCT assessment of the third molar region provided useful information regarding impacted mandibular third molar surgery operations.

scholarly journals Taking advantage of an unerupted third molar: a case report

2017 ◽  
Vol 22 (4) ◽  
pp. 97-101 ◽  
Author(s):  
Igor Figueiredo Pereira ◽  
Fernando Zander Mucci Santiago ◽  
Augusto Cesar Sette-Dias ◽  
Vladimir Reimar Augusto de Souza Noronha
Keyword(s):  
Root Resorption ◽  
Third Molar ◽  
Dental Arch ◽  
Third Molars ◽  
Supernumerary Tooth ◽  
Proper Position ◽  
Dental Surgery ◽  
Second Molar ◽  
The Third ◽  
Permanent Molar

ABSTRACT Introduction: Treatments with dental surgery seek to displace tooth to the correct position within the dental arch. Objective: To report a clinical case that took advantage of an unerupted third molar. Case history: A male patient, 18 years of age, was referred by his dentist to evaluate the third molars. The clinical exam revealed no visible lower third molars. The computed tomography (CT) exam showed the presence of a supernumerary tooth in the region of the mandibular ramus, on the left side, and impaction of the third molar, which was causing root resorption on the second molar, thus making it impossible to remain in the buccal cavity. The preferred option, therefore, was to remove both second molar and the supernumerary tooth, in addition to attaching a device to the third molar during surgery for further traction. Results: After 12 months, the third molar reached the proper position. Conclusion: When a mandibular second permanent molar shows an atypical root resorption, an impacted third molar can effectively substitute the tooth by using an appropriate orthodontic-surgical approach.

scholarly journals Coronectomy of the wisdom teeth: the dental extraction alternative

2021 ◽  
Vol 3 (59) ◽  
pp. 12-17
Author(s):  
Sergiu Beliniuc ◽  
◽  
Gabriela Motelica ◽  
Keyword(s):  
Inferior Alveolar Nerve ◽  
Third Molar ◽  
Mandibular Canal ◽  
Surgical Removal ◽  
Third Molars ◽  
Close Proximity ◽  
Wisdom Teeth ◽  
Low Incidence ◽  
Upper Third ◽  
Surgical Separation

Background. Coronectomy of the wisdom teeth is an alternative surgical procedure to tooth extraction, which aims to preserve the roots of the wisdom teeth in the dental socket after surgical separation of the crown, in order to avoid the injury of the inferior alveolar vascular-nervous bundle. Purpose. Minimizing the damage to the inferior alveolar nerve when extracting lower third molars caused by the intimate relationship between the nerve and the roots of the teeth, by using the technique of coronectomy, or intentional root retention. Material and Methods. Patients who reported to University Dental clinic during the period 2020–2021 for surgical removal of impacted L3M were screened for nerve–root relationship with OPG or CBCT. 15 patients underwent coronectomy as a procedure to remove the crown and upper third of the roots of a lower third molar to reduce the risk of damage to the inferior alveolar nerve. Results. 15 patients were enrolled in this study, with a total of 17 lower third molars. Sixteen sites healed primarily, but in 1 case the sockets on both sides opened and failed to close secondarily. In this case, the root fragments were later removed and found to be mobile. Conclusion. Coronectomies are safer to perform than complete extractions in situations in which the third molar is in close proximity to the mandibular canal. The technique appears to be associated with a low incidence of complications and the removal of remaining roots is required in around 6-7% of cases due to the mesial migration of the fragment and not any symptoms or reinfection.

scholarly journals Dental caries on distal surface of mandibular second molars

2015 ◽  
Vol 18 (1) ◽  
pp. 51 ◽  
Author(s):  
Hudson Oliveira Silva ◽  
Antonione Santos Bezerra Pinto ◽  
Moara E Silva Conceição Pinto ◽  
Marconi Raphael de Siqueira Rego ◽  
Jamyra Ferreira Gois ◽  
...  
Keyword(s):  
Third Molar ◽  
Dental Radiology ◽  
Third Molars ◽  
Inclusion Criteria ◽  
Panoramic Radiographs ◽  
Second Molar ◽  
The Third ◽  
Mandibular Third Molar ◽  
Distal Surface ◽  
Sliding Scale

<p><strong>Objective: </strong>The aim of the study was to evaluate the frequency of distal caries in the second molar influenced by the angulation of the third molar adjacent on panoramic radiographs in a clinical dental radiology. <strong>Material and</strong><strong> Methods: </strong>A descriptive and quantitative study that examined 750 panoramic radiographs, of this total, 120 were in accordance with the inclusion criteria of the study was conducted.<strong> Results: </strong>157 seconds and third molars analyzed the prevalence of caries in the distal of the second molar was 25.5%. The most prevalent angle position of the third molar was 57.3% with the vertical, but the position with the highest percentage of decayed molar second distal mesioangular was 50% of the cases. The elements listed, males obtained 40% of second molar distal caries versus 17% for females. People aged 35 or older had the highest incidence with 50% distal caries while other bands obtained 16.21% in the group 18-24 years, and 23.52% in 25-34 years. <strong> Conclusion: </strong>It was possible to establish a sliding scale on the indication for prophylactic removal of mandibular third molar according to the angulation of Winter: horizontal, mesioangular, vertical and distoangular. One can also see a greater relevance to the indication of prophylactic removal of male individuals aged over 35 years.</p>

scholarly journals Impact of CBCT on treatment decision related to surgical removal of impacted maxillary third molars: does CBCT change the surgical approach?

2019 ◽  
Vol 48 (8) ◽  
pp. 20190209 ◽  
Author(s):  
Louise Hermann ◽  
Ann Wenzel ◽  
Lars Schropp ◽  
Louise Hauge Matzen
Keyword(s):  
Initial Treatment ◽  
Root Resorption ◽  
Treatment Plan ◽  
Third Molar ◽  
Treatment Decision ◽  
Panoramic Image ◽  
Third Molars ◽  
Second Molar ◽  
The Third ◽  
External Root Resorption

Objectives: To assess factors influencing treatment decision for maxillary third molars referred for cone beam CT (CBCT). Parameters influencing the decision to treat and to remove either the maxillary second molar or third molar were pursued. Methods: 111 impacted maxillary third molars, clinically examined including a panoramic image, in 86 patients (mean age 26 years, range 15–55) were referred for CBCT on suspicion of pathology/root resorption in the second molar, based on information in the panoramic image. The following parameters were assessed from the patient’s file, including the radiographic images: (1) third molar angulation; (2) initial treatment plan based on clinical examination and the panoramic image; (3) diagnoses based on information from CBCT; (4) treatment decision after additional CBCT information was available; (5) pre-/post-operative complications; (6) treatment of the maxillary second molar. Results: 70 cases (63.1%) underwent treatment, while 41 (36.9%) received no treatment. Change in treatment plan was registered in 65 cases (58.6%) after CBCT. In 12 cases (10.8%), treatment changed from removal of the third to removal of the second molar, while 25 (22.5%) were scheduled for removal in the initial treatment plan; but after CBCT, the decision was not to treat. If external root resorption involved the pulp of the second molar, there was an almost 17 times higher risk that this tooth was removed instead of the third molar (logistic regression analysis: odds ratio 16.8; p < 0.001). Conclusions: Findings in CBCT often changed the treatment plan. Severe external root resorption observed in CBCT was the main decisive factor for removing the second instead of the third molar.

The Effects on the Lower Third Molar of the Extraction of the Lower Second Molar

1978 ◽  
Vol 5 (2) ◽  
pp. 99-103 ◽  
Author(s):  
John Lawlor
Keyword(s):  
Root Formation ◽  
Third Molar ◽  
Third Molars ◽  
Second Molar ◽  
Factors Associated ◽  
The Third ◽  
Lower Arch

A survey was carried out on 60 patients for whom lower second molar removal had been recommended at least 5 years previously, no other treatment being indicated in the lower arch. Of the 114 teeth recommended for removal, only 84 were extracted. Eighty four per cent of third molars erupted satisfactorily, where second molars had been extracted, while only 36 per cent of third molars erupted into good occlusion where the recommended extractions had not been carried out. In the extraction group, factors associated with a poor result were lack of third molar root formation at the time of removal of the second molar and space between the third molar crypt and the lamina dura of the second molar.

scholarly journals X-RAY ANALYSIS OF THE POSITION OF THE RUDIMENTS OF ABNORMALLY LOCATED LOWER THIRD MOLARS DURING THEIR FORMATION AND GROWTH

2020 ◽  
Vol 16 (1) ◽  
pp. 108-113
Author(s):  
Marina Morozova ◽  
Svetlana Dem'yanenko ◽  
Natalia Marchenka ◽  
Vyacheslav Kirichenko ◽  
Ekaterina Romanova ◽  
...  
Keyword(s):  
Negative Impact ◽  
Third Molar ◽  
Occlusal Plane ◽  
Optimal Timing ◽  
Third Molars ◽  
Measuring Device ◽  
X Ray ◽  
Second Molar ◽  
The Third ◽  
Negative Effect

Subject. The issues of indications, contraindications and the optimal timing for the removal of abnormally located lower third molars remain relevant in dentistry. Numerous evidence has been accumulated of their negative impact on the formation of the dentofacial system, however, X-ray patterns of patients with this pathology in the process of their formation, development and change in the angle of inclination, as well as the growing problems associated with the growth of these teeth in the dentition and bite have not been studied. The goal is to study the dynamics of the position of the rudiments of the abnormally located lower third molars in the process of their formation and growth and their influence on the state of the dentofacial system as a whole. Methodology. The study involved 28 patients with abnormally located impressive lower third molars, which were divided into 3 groups: in the first (8 people), the second molars were at the teething and growth stage, in the second (12 people) the second molar was in the occlusal plane at the stage closed apex, in the third (8 people) there was a multiple abnormal position of the mesially located teeth from the third molar. All measurements were performed using a virtual measuring device in the image mode of slices with Galileos Viewer software. Results. According to our results, a significant scatter was recorded in the timing of the formation of third molars from the period of mineralization of the crown of the teeth (12―15 years) to the end of growth and root formation (18―23 years). After 23 years, the roots of the abnormally located lower third molars in the patients examined by us had radiological signs of the end of formation (closed apex). Conclusion. Impact lower third molars continue their growth and have a negative effect on the condition of the teeth located mesial. This fact does not depend on concomitant orthodontic pathology, nor on the methods of orthodontic treatment (removable or non-removable equipment).

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